Abstract:[Objective]: To investigate the efficacy of the minimally invasive protocol of applying double counter-traction combined with minimally invasive percutaneous plate osteosynthesis (MIPPO) in the internal fixation with steel plate after the debridement for an open Schatzker type VI tibial plateau fracture. [Methods]: A retrospective study was conducted on 16 patients with open Schatzker type VI tibial plateau fractures who were admitted to our hospital from January 2016 to January and were treated with a minimally invasive protocol of using double counter-traction combined with MIPPO in the internal fixation. [Results]: All patients in this group were followed up for 14-30 months, with a mean of (20±5.68) months. And it took 4-8 months for the fracture to heal, with a mean of (6.14±1.35) months. No skin necrosis or major important neurovascular injury was found after the internal fixation. The line of gravity of lower limb healed well, and the patients were satisfied with the articular surface repositioning outcomes. Besides, no internal implant infection or internal fixation failure occurred. The HSS Knee Score at the last follow-up was 86-92(89.4±2.4), which was excellent. Rasmussen anatomical score for repositioning of tibial condyle fracture was 12-18 ( 14±1.6), with the good and excellent scores accounting for 100%.[Conclusion]: The minimally invasive protocol of double counter-traction combined with MIPPO in the internal fixation for the treatment of open Schatzker type VI tibial plateau fractures can achieve satisfactory fracture repositioning outcomes with minimal trauma. This solution can facilitate fracture healing so as to start functional exercises for knee joints early, avoid further necrosis of the already severely damaged skin and soft tissues and make internal fixation more reliable. So it is simple, easy to perform and needs to be widely applied.